Meningiomas are the most common intracranial tumors accounting for 20 to 30% of central nervous system tumors. Currently, only two risk factors have been highlighted: the history of exposure (therapeutic or accidental) to ionizing radiation, and some genetic predispositions syndromes in particular Neurofibromatosis type 2. Given the feminine predominance and the presence of progesterone receptors expression in meningiomas, authors began to focus on hormonal factors as a risk factor of meningioma especially drugs like cyproterone acetate. Cyproterone acetate (CPA) is an antiandrogen drug with a relative oral progestational activity of 1200. In France, CPA has market authorization for idiopathic hirsutism, polycystic ovary syndrome, for palliative treatment of prostatic carcinoma or sexual disorder. Knowing this background, we explored the potential relation between CPA exposure and meningiomas in a retrospective, multicentric cohort of meningiomas treated by surgery or/and radiotherapy. The aim of this study was to determine the prevalence of the use of cyproterone acetate among patients treated for meningiomas and we investigated the association between intracranial meningioma and sex hormone exposure. Eligible patients included all patients who went through neurosurgery with anatomopathological confirmed intracranial meningioma in the Nantes University Hospital Central and all patients who went through radiotherapy treatment for an intracranial meningioma in the René Gauducheau ICO Cancer Center (diagnostic was accepted based on the imaging) from January 1, 2014 to December 31, 2017. We excluded patients with NF2 mutation, previous radiotherapy exposure and extracranial meningiomas. Clinical data were retrospectively collected from medical records: age at diagnostic, sex, BMI, if the discovery was incidental or symptomatic, size of the tumor, localization, Simpson grade, anatomopathological characteristics of resected meningiomas (WHO grade, presence of hormonal receptors). We also collected the history of polycystic ovarian disease, breast cancer, prostatic cancer, number of pregnancies and children, the actual or past use of cyproterone acetate, tamoxifen, oral contraceptive, clomiphene or androgenic therapy. 388 patients (292 F, 96 M) were enrolled in the study, 277 treated by surgery and 111 treated by radiotherapy. 74 patients (69 F, 5M) (19%) had history of hormonal treatment, there was 15 (3.9%) patient with actual or past use of cyproterone acetate. More complete data will be available for the congress.
18 - 21 May 2019
European Society of Endocrinology